Q & A

How do children get PANS/PANDAS?

We believe children who develop PANS or PANDAS have a genetic predisposition for these syndromes, which are triggered by an environmental stressor, often an infection. With PANS, that trigger is unknown. PANDAS is thought to be triggered by a Streptococcal infection. Blood tests conducted on children with PANS may show signs of inflammation. We carefully examine the results in context of each child’s illness.

How common is PANS/PANDAS?

There hasn’t been a large population study on the incidence of PANS or PANDAS, so we don’t know how common they are. PANS and PANDAS are often overlooked by medical doctors because of the assumption that there is not an underlying medical cause for the patient’s psychiatric symptoms.

How is PANS/PANDAS treated?

What should I do if I think my child has PANS or PANDAS?

Parents whose child has a dramatic onset of OCD, suddenly restricts his/her food intake, abruptly develops tics and at the same time is experiencing sudden severe neuropsychiatric symptoms - anxiety, irritability, uncontrolled emotions, and/or depression – should see their child's pediatrician and have refer their pediatrician immediately refer their child to our clinic for a visit if they live within a 90-mile radius of Stanford and symptoms began within one month. If the affected family resides outside 90 miles of Lucile Packard Children's Hospital Stanford in Palo Alto, parents should have the child's pediatrician test for strep. Resources for pediatricians may be found at PANDAS Physician Network and our website: http://med.stanford.edu/pans.html.

The referral will only be considered in through the proper referral process to our clinic, initiated by the child's physician.

Meeting the conditions above does not guarantee that the clinic will be able to accomodate or accept the referral.

It is advised that the pediatrician test the child for both a rapid strep throat, and if negative, by culture.

A peri-anal rapid strep test would be recommended if the patient is also experiencing rash, pain, redness or itching.

If any of these tests are positive, the child needs to be put on antibiotics for strep.

If rapid strep tests and cultures are negative, the child should have blood tests for strep.

If the child has had or been exposed to an illness with prolonged coughing, then the child's pediatrician may consider testing for a bacteria called mycoplasma.

What is the prognosis for a child with PANS/PANDAS?

For children who are diagnosed early and a cause has been identified, the prognosis can be very good. Some patients respond quickly and are back to 100 percent normal function, but that doesn’t happen for everybody. For those in whom the cause is unknown and who don’t respond as well to antibiotics, we continue to treat the children and work with their families to address their illnesses.

We also recommend visiting the following websites, which may be helpful to you: